Some 12 million Americans visit medical professionals annually for earwax removal. Millions more have it done at spas and ear-candling parlors, which theoretically suck out earwax with a lighted candle. North Americans also spent $63 million last year on home ear-cleaning products, from drops to irrigation kits, according to market research firm Euromonitor International.

Doctors, who generally recommend against mining for earwax with swabs, are particularly incensed about people who get candling done. The procedure involves a long, hollow cone-shaped candle placed in the ear. The outside end of the candle is lighted, supposedly creating a vacuum inside that draws out the wax. One physician in the Journal story called it “the work of the devil.”

Generally, say doctors, the body does a perfectly fine job of getting rid of earwax without any help from outside implements. Physicians pretty much stand by the old saying “Don’t put anything in your ear smaller than your elbow.” This is because there’s a risk of puncturing the eardrum, causing tinnitus, or further packing in the earwax, “like loading a Civil War cannon,” as one pediatrician quipped.

On the other hand, wearing hearing aids, earbud headphones or earplugs for extended periods can cause earwax buildup. Impacted earwax, which gets pushed down the ear canal, affects up to 57 percent of older patients in nursing homes, according to the American Academy of Otolaryngology-Head and Neck Surgery. Excess earwax is also the most common – and most treatable – cause of partial hearing loss.

As the Journal points out, “Aside from earwax overproducers, who can benefit from a professional cleaning a few times a year, doctors say the average person should not require ear cleaning unless the wax is causing bothersome symptoms or impeding a doctor’s ability to examine the eardrum.”